NPI | 1962676668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME126244) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2008-04-15 |
Last Update Date | 2016-03-25 |